ECE2021 Audio Eposter Presentations Calcium and Bone (75 abstracts)
1Tahar Sfar Hospital mahdia, ENT department, mahdia, Tunisia; 2Tahar Sfar Hospital Mahdia, ENT department, Sfax, Tunisia
Objective
Illustrate the interest of imaging: Single photo emission tomography or Computed tomography in the topographic diagnosis of parathyroid adenomas.
Observation
A 67-year-old man, with renal lithiasis presenting a clinical-biological picture of primary hyperparathyroidism with renal bone and colic pain. PTH was 463.2 pg/ml, calcemia 3.4 mmol/l. Cervical ultrasound objectified a lesion suspected of parathyroid adenoma. A first scan objectified a hyperfixative focus that projects against the lower pole of the thyroid.The patient had surgery. No post-operative problem were referred. We noted a persistence of elevated serum PTH and calcemia values. Pathology examination found a benign thyroid nodule. A SPECT/CT was then performed objecting a hyperfixative focal spot whose scanno-scintigraphic configuration corresponds to a very posterior nodular formation of 20 mm right lateral-esophageal and prevalent at D2. The diagnosis of atypical parathyroid localization was retained. The patient had a surgical revision with a right lower parathyroid adenoma of 30 * 20 mm near the pre-vertebral plan. Post-operative outcomes were simple with clinical improvement and normalization of biological numbers.
Conclusion
The SPECT/CT plays a decisive role in the management of patients with persistent or recurrent hyperparathyroidism. It is most often used to visualize atypical parathyroid adenomas and to guide the surgeon.